Association between clustering of cardiovascular risk factors and left ventricular geometric remodeling in Chinese children

Qin Liu; Huan Wang; Min Zhao; Cheng Zhang; Pascal Bovet; Bo Xi

doi:10.3389/fcvm.2023.1236730

Association between clustering of cardiovascular risk factors and left ventricular geometric remodeling in Chinese children

Front Cardiovasc Med. 2023 Aug 17:10:1236730. doi: 10.3389/fcvm.2023.1236730. eCollection 2023.

Authors

Qin Liu¹, Huan Wang², Min Zhao³, Cheng Zhang⁴, Pascal Bovet⁵, Bo Xi⁶

Affiliations

¹ Department of Ultrasound, Children's Hospital of the Capital Institute of Pediatrics, Beijing, China.
² Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China.
³ Department of Toxicology and Nutrition, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
⁴ Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
⁵ Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
⁶ Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.

Abstract

Background: Several cardiovascular (CV) risk factors are reported to be associated with abnormal cardiac structure in children and adults. However, no study has assessed the association between clustering of multiple CV risk factors and left ventricular geometric (LVG) remodeling. We examined the association between clustering of CV risk factors and LVG remodeling among Chinese children.

Methods: This cross-sectional study included 1,406 children aged 6-11 years. Clustering of CV risk factors was quantified as the sum of the number of five CV risk factors (abdominal obesity, elevated blood pressure, high fasting blood glucose, high triglycerides and low high-density lipoprotein cholesterol). Based on left ventricular mass index and relative wall thickness (RWT), left ventricular hypertrophy (LVH), high RWT and LVG remodeling [concentric remodeling (CR), eccentric hypertrophy (EH) and concentric hypertrophy (CH)] were defined.

Results: Compared to participants without CV risk factor, those with 1, 2 and ≥3 risk factors were at increased risk of LVH [ORs (95% CIs): 3.49 (2.19-5.56), 5.53 (3.20-9.55), and 19.19 (9.67-38.08), respectively]; corresponding values for high RWT were 2.47 (1.63-3.74), 3.76 (2.25-6.27), and 5.47 (2.65-11.28). Similar associations between clustering of CV risk factors and LVG remodeling were found [CR: 1.71 (1.06-2.76), 2.83 (1.54-5.18), and 3.82 (1.37-10.62); EH: 2.42 (1.42-4.11), 4.23 (2.24-7.96), and 16.86 (7.70-36.92); CH: 14.92 (4.41-50.47), 23.15 (6.32-84.83), and 71.19 (17.09-296.56)].

Conclusion: CV risk factors in isolation and combination were associated with an increased risk of LVH, high RWT and LVG remodeling among children, emphasizing the need to consider multiple risk factors when assessing the risk of cardiac outcomes.

Keywords: Chinese; cardiovascular risk factor; children; geometric remodeling; left ventricle.

Grants and funding

This work was supported by the National Natural Science Foundation of China (81673195, 81722039). The funders had no role in the design, analysis, or submission of the prepared manuscript.